My husband and I had a family practice in Arcata, California, for 28 years, during which time we learned the importance of addressing the patient’s context outside of the medical visit in order to maximize health and self-efficacy. We went to great lengths to keep patients out of the ER and hospital.  I saw one patient with massive pedal edema twice weekly for months to wrap her legs, since she lived ...

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The Pap smear, in which a clinician gently scrapes and brushes cells from a woman's cervix (the lower portion of her uterus or womb), swishes them in a bottle of fixative solution, and then sends them to the lab to determine if the cells show pre-cancerous or cancerous changes caused by the sexually transmitted human papilloma virus (HPV), is a pretty simple procedure that takes less than a minute to ...

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Faith.  A simple word with complicated meaning.  It is a seed buried deep within our spiritual cores, ready to be nourished and blossom with the sprinklings of tragedy.  It is a belief that things will work out, despite our lack of vision for fate's secretive reasons of the bumpy journey we must endure.  It is an inherent hope that has either sustained us or has failed us miserably.  Yes, to ...

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With all of its frustrations and challenges, I love my job.  In fact, the very things that make primary care so difficult and often times exhausting are also what make it in my opinion the most awesome field in medicine. When I was in grade school, I wanted to be a physician.  My parents would take me to the pediatrician for routine check-ups or when I wasn't feeling so great and I remember ...

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I’ve been asked to appear on a radio talk show to discuss one of my blog articles.  It seems that the producers of the show were impressed by my article on the beauty of medicine when it works the way it’s supposed to. “When It Works Right, It’s a Thing of Beauty” was published this summer and is one of my favorite articles.  The practice of medicine is a beautiful thing.  ...

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Let’s all agree on two things. First, that energy independence is good for our country. Second that clean drinking water is also good for the country. The development of America’s huge stores of natural gas, have given us a remarkable opportunity to accomplish the former. In particular, the process of “fracking” has made it possible to increasingly tap those huge natural gas stores.  Natural gas sits in rock formations, but releasing it ...

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Over the past several decades medical costs in the United States have escalated rapidly, exceeding the pace of inflation and threatening bankrupt to Medicare.   As we heard in last week’s presidential debate, different solutions have been proposed on how to slow Medicare’s growth and reduce cost.  President Obama highlighted his administration’s success in tackling fraud and waste within the system. This strategy appears to be supported across party lines.  On ...

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It happened again three times in clinic today.  In the middle of a patient visit, a parent picked up their cell phone.  To answer a call, to text a friend, to read their email.  The trend of being always connected and available has reached the exam room.  When this first started happening I was sort of incredulous.  I mean, I’m there, talking to you about your child’s health, and you’re ...

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Some cases burn into your brain like a hot branding iron, for whatever reason, and never really leave.  This was one of those cases. One hectic morning before my shift, my wife and I rushed around the house trying to get our kids ready for school.  On this day, my daughter was to go on a field trip where the teachers would walk the kids through the city to the local ...

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Health care reform is a locomotive barreling down America's tracks. In two years, the Affordable Care Act (ACA) will cover some 30 out of 50 million of us that currently lack health insurance. Political beliefs aside, it would seem that supplying insurance to protect the health of more people is a societal good. Though the costs of reform will be debated for years to come, one major question remains that ...

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